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Sharma S, Basalingappa S, Revankar AV, Patil AK.

Orthodontic extraoral photography: Comparative
subjective analysis of five...

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Original Article

Orthodontic extraoral photography: Comparative

subjective analysis of five digital single lens reflex
cameras

Sumedha Sharma, Abstract

Sangamesh Basalingappa,
Ameet V. Revankar,
Anand K. Patil
Department of Orthodontics and
Dentofacial Orthopedics, SDMCDS,
Dharwad, Karnataka, India
Objectives: To compare 5 digital single lens reflex cameras (DSLRs) for extraoral
photography in the orthodontic office, to recognize the best camera and the best mode
for each camera. Materials and Methods: 5 DSLRs namely Canon 500D, Canon 550D,
Nikon D3100, Nikon D40 and Nikon D5000 were compared. Images were clicked in
auto mode, program mode, manual mode, macro mode and aperture priority mode.
Same settings were used for all cameras. Thirteen orthodontists were asked to rank the
images for quality. Data was collected and statistically analyzed using Kruskall Wallis
analysis of variance. Results: Canon 500D ranked the highest (P < 0.001) for auto,
program and macro mode, closely followed by Canon 550D (P < 0.001), which ranked
highest for portrait mode and manual mode. Conclusion: Images by Canon 500D and
Canon 550D were perceived better than Nikon for the chosen settings, establishing ease
of use for these cameras. This study gives a basic idea regarding technical specifications
that can be used for a particular camera for extraoral photography.
Key words: Digital, extraoral, orthodontics, photography

INTRODUCTION no film expense and easy and quick deletion of poor

Extraoral photos are indispensable for documentation,
communication and as a diagnostic tool in orthodontics.
The art of diagnosis has evolved from intraoral aids
such as plaster models to cephalometric radiography,
digital imaging and to 3D reconstruction of images to
life like models using computer software. Nonetheless,
simple 2D digital imaging forms the most commonly
employed tool for orthodontic diagnosis. It is simple,
inexpensive (except for the initial investment) and very
informative in terms of diagnostic value. Furthermore,
there is ease of editing, improved communication;
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DOI:
10.4103/2321-1407.119094
images with the advent of digital photography.[1] The
digital single lens reflex  (DSLR) cameras available
commercially are commonly employed for the same,
as these have become quite affordable over time.[2]
Many of the authors have previously tested DSLRs
for intraoral photography.[3,4] Since extraoral imaging
is equally important for orthodontic diagnosis and
treatment planning, the same was considered in this
study. Such comparative studies have been conducted
previously,[5] but none has been undertaken recently.
All DSLRs used for this study are comparable in terms
of technical specifications and are capable of producing
images of good resolution, with a wide range of depth
of field, good color reproduction and sharpness once
properly adjusted. Therefore, this study aims at
comparing the images produced by these cameras at a
specific setting with minimal adjustments, thus assessing
user friendliness of the camera.

Address for correspondence:

Dr. Sumedha Sharma, Department of Orthodontics, SDMCDS, Karnataka, India. E‑mail: sumedha_sharma518@hotmail.com

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Sharma, et al.: Extraoral photography for orthodontic diagnosis

AIM tripod placed at a fixed distance of 3 feet from the subject

Aim of this study was to compare five different DSLR
cameras in different modes for extraoral photography in
orthodontic clinic.
OBJECTIVES
• To determine, which camera produced the best image
in a particular mode
• To recognize the best mode for a particular camera for
extra oral photography.
MATERIALS AND METHODS
The study was conducted in the Department of
Orthodontics and Dentofacial Orthopedics, SDM
College of Dental Sciences, Dharwad, Karnataka,
India. Five different commercially available DSLR
cameras were selected for the study. Following are few
important technical specifications [Table 1].
All pictures were taken in the photography room with
wall mounted flood lights‑110 V AC units [Figure 1].
The subject was photographed by the same operator
using all cameras. The camera was stabilized using a
being photographed against a white background. 18‑55
mm lens was used with all cameras. Only full face extra
oral view was taken for the comparison. The images
were taken in Auto mode, Program mode, Portrait
mode, Macro mode, Aperture priority mode and
Manual mode. Although Auto, Portrait and Macro
modes have automatic adjustments in all cameras,
manual adjustments were required for Program mode,
Aperture priority mode and Manual mode.
Auto mode
In this mode, shutter speed, aperture, ISO, white
balance, focus and flash are all adjusted by the camera
automatically.
Portrait mode
The camera adjusts automatically and depth of field is
low in this mode, so that the background appears blurred.
Macro mode
This mode is usually used for shooting close objects,
like intraoral pictures. However, to facilitate comparison,
here the same extraoral photos were taken in this mode
also. Depth of field is again low in this case and focusing
distance may vary among different cameras.
Program mode
Here, aperture and shutter speed are adjusted automatically.
ISO 800 was used for all cameras. ISO basically determines
the sensitivity of the sensor to light. Higher the ISO, higher
is the amount of light captured. However, it is not an
absolute value as ISO definition relates to the fraction of
light relative to the full capacity, not the total light collected.
Higher ISO settings are required in low light conditions,
but this also increases image noise.

Aperture priority mode

In this mode, aperture and ISO can be changed while
shutter speed is adjusted by the camera automatically.
Following aperture settings were used:
• F = 5.6
• F = 8
• F = 16
Figure 1: Photography room with wall mounted flood units • F = 29.

Table 1: Technical specifications of the cameras used for the study

Feature Nikon D5000 Nikon D3100 Nikon D40 Canon 550D Canon 500D
Effective pixels (in millions) 12.3 14.2 6.1 18.0 15.1
Sensor size (mm) 23.6×15.8 23.1×15.4 23.7×15.6 22.3×14.9 22.3×14.9
Continuous shooting speed 4 frames/s 3 frames/s 2.5 frames/s 3.7 frames/s 3.4 frames/s
ISO sensitivity ISO 200‑3200 100‑3200 200‑1600 100-6400 100-1600
Monitor size 2.7 inches diagonal 3.0 inches 2.5 inches 3 inches 3 inches
ISO = International organization for standardization

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ISO was kept constant at 800. As the F number increases,
the aperture’s size decreases and the depth of field
increases.
Manual mode
Settings used were ISO: 800, f = 5.6, shutter speed =
1/125 s.
Flash compensation was set at 0 for all cameras. Picture
quality was set at fine, large size in JPEG format and
white balance was set at auto. Picture saturation,
contrast and sharpness were set at zero for all cameras.
Images were displayed on a computer screen (Hp
pavilion g6 2210 notebook) and thirteen orthodontists
were asked to rank the images for quality, which were
completely “anonymized” [Figure 2]. The laptop screen
was placed at eye level of the observer, who was seated
at a distance of 1.5 feet from the screen. Images were
given rank from 1 to 5, 1 being the best image and 5
being the worst.
Statistical analysis
All the results were collected and analyzed using “SPSS
10.0., IBM corporation” The collected data was subjected
to Kruskall Wallis test.
f = 16 and f = 29 and program mode (P < 0.001). It was
closely followed by Canon 550 D, which gave best images
in the remaining modes, i.e., Aperture priority mode with
settings f = 5.6, f = 8, portrait mode and manual mode
(P < 0.001). Nikon D3100, Nikon D40 and Nikon D5000
produced relatively inferior results than Canon 500D and
550D (P < 0.001) [Table 2]. Mode wise comparison is as
follows:
Auto mode
Canon 500D was ranked best (P = 0.04). Image was
sharp, with good colour reproduction. Canon 550D
was the next best, with image slightly lacking in
exposure (P = 0.93). This was followed by Nikon
D3100, which gave an image with increased emphasis
on red (P < 0.001). Nikon D40 image was slightly
underexposed, while Nikon D5000 image put more
emphasis on blue.
Portrait mode
Canon 550D produced the best image (P < 0.001) followed
by canon 500D, for which color temperature was slightly
low. Nikon D40 image ranked third with good color
reproduction and adequate exposure. Nikon D3100 and
Nikon D5000 lacked in exposure.

RESULTS
Canon 500D was ranked the best out of all cameras in
auto mode, macro mode, aperture priority with settings
Program mode
Canon 500D gave the best image (P < 0.001). Canon
550D image color temperature was considerably
increased, putting great emphasis on red. Nikon
D3100 and D40 lacked exposure, while Nikon D5000

Figure 2: Images were displayed on the computer screen. The mode and camera were not disclosed to the observer

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Table 2: Comparison of quality of orthodontic photography taken by different modes using 5 different
SLR cameras
SLR type Mode Mode Mode Mode Mode Mode Mode Mode Mode Chi square P value*
1 2 3 4 5 6 7 8 9 value
Canon 500D
Mean 2.23 2.15 1.77# 1.62# 1.54# 1.46# 2.54 2.08 1.92# 15.87 0.04
Median 2.00 2.00 2.00 2.00 1.00$ 1.00 2.00 2.00 2.00
SD 1.09 0.99 0.60 0.65 0.66 0.78 0.97 0.86 0.86
Canon 550D
Mean 1.92# 1.77# 1.85 2.15 2.23 2.31 2.15# 1.92# 2.00 3.01 0.93
Median 1.00 1.00$ 1.00 2.00 2.00 2.00 2.00 1.00 2.00
SD 1.19 1.01 1.14 1.21 1.24 1.25 1.14 1.19 1.08
Nikon D3100
Mean 2.69 2.46$ 3.31 4.38 3.23 2.69 2.69 3.77 2.77 32.43 <0.001
Median 2.00 2.00 3.00 4.00 3.00 3.00 3.00 4.00 3.00
SD 1.18 1.05 1.18 0.65 1.01 0.63 1.18 0.83 1.09
Nikon D40
Mean 3.38 3.85 3.54 2.77 3.85 4.54 2.62 2.54$ 3.62 39.81 <0.001
Median 4.00 4.00 4.00 3.00 4.00 5.00 3.00 3.00 4.00
SD 0.96 0.38 1.05 1.09 0.90 0.97 1.26 1.05 0.77
Nikon D5000
Mean 4.77 4.77 4.54 4.08 4.15 4.00$ 5.00 4.69 4.69 31.41 <0.001
Median 5.00 5.00 5.00 4.00 5.00 4.00 5.00 5.00 5.00
SD 0.60 0.83 0.78 1.04 1.34 0.71 0.00 0.85 1.11
Chi square value 32.79 40.74 35.82 36.88 30.90 40.36 33.09 36.35 34.91
P value^ <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001
SLR = Single lens reflex; SD = Standard deviation. #The best camera for a particular mode; $The best mode for each camera;*Comparison of different modes within a SLR
camera (Kruskall Wallis ANOVA); ^Comparison of different SLR cameras within a mode (Kruskall Wallis ANOVA). Mode 1 = Aperture priority mode (f=5.6); Mode 2 = Aperture
priority (f=8); Mode 3 = Aperture priority (f=16); Mode 4 = Aperture priority (f=29); Mode 5 = Auto mode; Mode 6 = Macro mode; Mode 7 = Manual mode; Mode 8 = Portrait
mode; Mode 9 = Program mode

lacked exposure as well as color reproduction. These
results, however, were with one particular setting for
all cameras, as described above.
Manual mode
Canon 550D produced best image (P < 0.001). However,
color temperature was slightly higher. Canon 500D was
ranked next best, followed by Nikon D40, Nikon D3100
and Nikon D5000 respectively.
Macro mode
Canon 500D gave the best image (P < 0.001) followed by
Canon 550D, Nikon D3100 and Nikon D5000. Exposure
was low for Nikon D5000. Nikon D40 image was highly
overexposed.
Best results were obtained for Canon 500D using Auto
mode, for Canon 550D and Nikon D3100 using aperture
priority mode with f = 8 setting, for Nikon D40 using
the portrait mode and for Nikon D5000 using the macro
mode [Graph 1].
DISCUSSION
This study was principally aimed at comparing 5
DSLRs for extraoral photography. The results obtained
show that Canon 500D produced subjectively superior
images, followed by Canon 550D, which produced
comparable results. Nikon D3100, D40 and D5000
gave relatively poor images for the same settings.

Aperture priority mode
For f = 5.6 and f = 8, Canon 500D gave the best
image (P < 0.001) followed by Canon 550D, Nikon
D3100, Nikon D40 and Nikon D5000 respectively.
However, for f = 16, Canon 550D ranked better than
Canon 500D (P < 0.001). Overall, an aperture setting of
f = 16 produced acceptable images for all cameras. For
f = 29 setting, Nikon D3100 image was ranked least with
considerably reduced exposure.
It was found that images obtained by Nikon DSLRs
were often ranked low owing to underexposure.
In order to obtain correct exposure, the ISO speed
setting can be adjusted. When a higher ISO setting
is used, the camera sensor becomes more sensitive
to light, thus increasing exposure. However, this
increases image noise and should therefore be used
cautiously. Other functions like flash compensation
and exposure compensation can also be altered when

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Graph 1: Comparison of the results for each camera in every mode. Mode 1: Aperture priority mode (f = 5.6), Mode 2: Aperture priority (f = 8),
Mode 3: Aperture priority (f = 16), Mode 4: Aperture priority (f = 29), Mode 5: Auto mode, Mode 6: Macro mode, Mode 7: Manual mode, Mode 8:
Portrait mode, Mode 9: Program mode

using the manual mode. In modes where aperture
settings can be changed, using a lesser f value will
increase the aperture size, thus increasing the amount
of light entering the camera. However, it should be
kept in mind that changing f value alters depth of field
as well. Lesser f value gives lesser the depth of field.
This is desirable for extraoral portrait photography,
as it blurs the background, keeping only the subject
of interest in focus. Other than these settings, various
computer softwares provide the options to alter the
image exposure and brightness. The drawback here
is that in case the image is already overexposed, not
much can be done to fix it, even if the image is taken in
RAW format, which generally gives greater freedom
of processing. It is always better to produce slightly
underexposed image than an overexposed one.
In many modes, Canon 550D produced image with
increased color temperature accounting for lower
ranking obtained as compared to Canon500D. To assess
color reproduction, the image must be compared with
the actual subject. The difference in color reproduction
reflects manufacturing difference in color weighting.
All cameras color render images, i.e., they alter the
actual colors while constructing the image. To avoid
color rendering, image may be taken in RAW format.
This reduces the image processing by the camera, but
does not completely eliminate color rendering. To
obtain the desired color, the “white balance” function
may be manually adjusted. This was set at auto for the
present study.
Color rendering may also occur when the image is
displayed on the computer screen, or is printed. To
minimize this, various color management systems have
evolved (International color consortium).[6]
If we compare Nikon D40 and Nikon D5000, images
produced by Nikon D40 were better ranked. This is
interesting, considering the fact that Nikon D40 is a 6.1
Megapixel camera compared to Nikon D5000, which
is a 12.3 Megapixel. This is probably because since the
sensor size of the two is the same, size of pixels is smaller
for Nikon D5000. Pixel size, though less considered, is
an important factor that affects image quality. Greater
pixel size allows greater detail to be captured per pixel,
thus decreasing image noise, particularly at high ISO
levels.[7]
This study was conducted using popular entry level
DSLRs available at the time. Quite recently, new
cameras have been announced by Canon and Nikon.
Nikon D3200, announced in April 2012 and Nikon
D5200, announced in November 2012 are the new
entries, which lie within the same price range. Nikon
D3200 is said to have good image quality and might
be very useful if one is willing to invest in good lenses.
Nikon D5200 has a sophisticated 39 point autofocus
system and improved version of D3200 sensor.[8]
CONCLUSION
Extraoral photography is an important part of
orthodontic diagnosis and effort should be made to
produce quality images, which are also necessary
for publications and case presentations. This study
compared 5 commonly used DSLRs and results showed
Canon 500D and Canon 550D to be better than Nikon

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Sharma, et al.: Extraoral photography for orthodontic diagnosis
D40, D5000 and D3100 with minimal adjustments.
This assessment was subjective and may be attributed
to one’s perception of color saturation and vibrance.
Comparable images may be produced by all cameras
by altering various settings as described, but this
requires experience and time. This study also provides
baseline data for further studies, which may focus on
comparison of more recent cameras, with other settings
that may provide better results. Since technology is
a constantly advancing field, it is important to keep
one‑self updated if one strives for excellence.
REFERENCES
1. Gallegos AG. Enhancing interprofessional communication through
digital photography. J Calif Dent Assoc 2001;29:752‑7.
136
View publication stats
2. Bengel W. Digital photography in the dental practice: An
overview (II). Int J Comput Dent 2000;3:121‑32.
3. Sandler J, Murray A. Digital photography in orthodontics. J Orthod
2001;28:197‑201.
4. Doldo T, Fiorelli G, Patanè B. A comparison of three digital cameras
for intraoral photography. J Clin Orthod 1999;33:588‑93.
5. Bister D, Mordarai F, Aveling RM. Comparison of 10 digital SLR
cameras for orthodontic photography. J Orthod 2006;33:223‑30.
6. International color consortium website. Available from: http://www.
color.org. [Last accessed 2012 Sep 09].
7. Digital cameras: Does pixel size matter?, 2005. Available from: http://
www.clarkvision.com. [Last accessed 2012 Sep 20].
8. Pillai KM. Top 30 cameras. Better photography 2013;16:56‑7.
How to cite this article: Sharma S, Basalingappa S, Revankar AV,
Patil AK. Orthodontic extraoral photography: Comparative subjective
analysis of five digital single lens reflex cameras. APOS Trends Orthod
2013;3:131-6.
Source of Support: Nil. Conflict of Interest: None declared.
APOS Trends in Orthodontics | September 2013 | Vol 3 | Issue 5